Describe and
evaluate differences between deontological and consequentialist
ethics.

KEY
POINTS

Consequentialism. There is one ultimate
moral aim that outcomes be as good as possible.

Act
consequentialism. An action is right if it
produces the best outcome possible.

Rule
consequentialism. A rule is right if it
produces the best outcome possible. This can be determined by
considering the question, what would happen if everyone did this sort of
thing. For example, possibly a rule such as ‘One ought to be
honest' could be justified on the grounds that if practiced generally
this would yield a good outcome.

Hedonistic
consequentialism. Outcomes are right in
proportion as they produce happiness and wrong as they tend to produce
the reverse of happiness. Happiness is understood as
the mental state of pleasure and the absence of pain.

Interest
consequentialism. Outcomes are right in
proportion as they produce the satisfaction of the interests of those
affected.

Categorical
Imperative.
‘Act only on the maxim through which you can at the same time
will that it should become a universal law'.

2.1 JUSTIFICATION OF
ETHICAL PRINCIPLES

In the examples that we considered
in Section
1, we saw that there
are four main principles appealed to in ethical
decision making:

Principle of Beneficence,

Principle of Autonomy,

Principle of
Non-malfeasance and

Principle of
Justice.

In the following example, three of
these principles are considered.

The Cancer
Example

An individual has cancer and asks a
member of the health-care team, in this case a nurse, what is wrong with him.
The nurse knows from close relatives of the cancer sufferer that he will be
overcome by depression if he knows the true diagnosis. He has the prospect of a
few more months of life with some pain that could be alleviated by drugs. It
seems reasonable to suppose that the quality of life of the sufferer in these
last few months will be better if he does not know the truth of his diagnosis.
Should the nurse tell him what is wrong with him?

The Principle of
Autonomy is clearly
relevant here. The right to be told one's true medical condition would appear to
he an area over which an individual has a right to be self-governing. This
knowledge might affect how the individual would like to conduct the last few
months of his life. For example, there might be certain things that he would
choose to say to those who have been close to him. Also, he might choose to
spend the last few months at home, if this was possible, rather than in
hospital.

However, it might be argued that
application of the Principles of Beneficence and Non-malfeasance favor not
telling this individual the true diagnosis. It might be assumed that harm would
be done to the individual if he knows, since then he will be overcome by
depression. Since the Principle of Non-malfeasance states that one ought not to
do harm, application of this principle would appear to favor non­disclosure.
Put positively, the Principle of Beneficence is applicable since the duty to
benefit here might be assumed to be accomplished by not telling the individual
the truth. Therefore, in this case it would appear that application of the
Principle of Autonomy favors a different action to that which would result from
applying the Principles of Beneficence and Non-malfeasance. Although we have a
clearer understanding of the nature of our dilemma by making explicit the
principles that are only present implicitly in the description of the case, we
have not been able to determine which course of action the nurse should
take.

What we need is a further
understanding of how these principles can in turn be justified. We need to know
what considerations fundamentally underpin the way that we look at ethical
dilemmas. For instance, in this example we might say that what we are
fundamentally trying to achieve is the best outcome in this case. We want to
reach a decision that will yield the best results or consequences for the
individual concerned, his relatives and others such as health-care workers
involved with his case. This is the essence of consequentialist ethical theories
(see ET1008: Section 12: 3.1 and
3.2).

2.2 CONSEQUENTIALIST
ETHICAL THEORIES

The view that what is
important is that the best consequences are achieved has been formulated by
Parfit as:

‘. . .
there is one ultimate moral aim: that
outcomes be as good as possible.‘ 2

Therefore, in the
‘cancer
example', we should be
asking:‘What will produce the best outcome in this situation?'
This is the fundamental question that we need to ask when we look at ethical
dilemmas.

2.2.1 Act
consequentialism

There are different ways in which we
might seek to answer the question of what will produce the best outcome in
ethical dilemmas. In the ‘cancer example' we might ask directly:‘What is the right action for the nurse to
perform?' and not make any reference to the three principles mentioned
above. If we did this, we should only consider the consequences on the
individual, relatives and other members of the health-care team of the nurse's
action of telling or not. The consequentialist view of what would make her
action right would be that an action is right if
it produces the best possible outcome.

If we approached the question in
this way, we would first of all have to determine what is the best outcome and
then from this it would follow what is the right action to perform. The right
action would be that one which would, on this occasion, produce the best
consequences. What is to count as the right action therefore becomes something
that is dependent on the ethical decision about what is the best outcome. Thus,
rightness is defined in terms of what produces good outcomes.

2.2.2. Rule
consequentialism

In order to avoid what might turn
out to be a lengthy examination in each separate case of what is going to yield
the best outcomes, it might be suggested that certain principles or rules could
be justified on consequentialist grounds. If this could be done, then when a
principle with a consequentialist justification is applicable in a certain case,
we would know that adoption of this principle is likely to lead to good
outcomes. Instead of applying the consequentialist justification directly to
acts, we should be using it to justify certain rules or principles. Thus we have
a
rule is right if it produces the best outcome possible.

In Sections 4, 5 and 6 we shall consider how the
Principles of Autonomy, Beneficence, Non-malfeasance and Justice might be
justified on consequentialist grounds.

Other rules might also be considered
as justifiable on consequentialist grounds. Thus, in the ‘cancer
example', it might be
the case that the rule, ‘One ought to tell the truth,' has a
consequentialist justification. Acting in accordance with this rule is likely to
produce the best consequences. If this is the case, the right action to perform
from this point of view would be for the nurse to tell the truth. The right
action is the one that is in conformity with the rule which has a
consequentialist justification.

This way of applying the
consequentialist, doctrine is indirect, as opposed to the direct application
considered in the act consequentialist approach. We are not considering the
consequences of an individual action but evaluating an action as right because
it falls under a rule that has a consequentialist justification. In the 'cancer
example', we are not considering directly the consequences of the nurses action
in this particular case. Rather, we are evaluating the nurse's action of telling
the truth as being right because the rule, ‘One ought to tell the truth',
has a consequentialist justification.

What are good
outcomes?

Whichever of these two approaches is
adopted, the doctrine that outcomes be as good as possible does not give us a
complete ethical theory. We need to know what are to count as good outcomes in
order to apply either our act or rule consequentialist doctrine. We need to
attach a value theory to our consequentialist claim which will tell us what are
good consequences.

There are many different views about
what are to count as good consequences. These views all claim that what is good
is fundamental. That is, no further justification can be given for what is taken
to be a good outcome; it just is good. Another way of making the same point is
to say that what is good has intrinsic worth. It is not good because of
something else that it might yield, it is good in itself.

These views are still described as
consequentialist theories but differ in the view they take about what has
ultimate value. In looking at these different value theories that can be
combined with consequentialism, we do not discuss whether the particular author
is applying consequentialism to individual actions or to rules. Our concern will
simply be to examine the value theory that is being proposed. Application of
these theories to the four principles is considered later.

2.2.3 Hedonistic
consequentialism (utilitarianism)

The classic consequentialist
doctrine is that put forward by Bentham4 and later by Mill5. Although they put forward
different accounts, they agree on the fundamental point that what has ultimate
value is happiness. Good outcomes are those that yield happiness. This view has
a certain initial plausibility that makes it worth examining. If we take the
‘cancer
example', we are trying
to achieve as much happiness as possible for the individual and others affected
in the situation.

Mill wrote:

‘The creed which accepts as the foundation of morals, Utility, or the
Greatest Happiness Principle, holds that actions are right in Proportion as
they tend to produce happiness, wrong as they tend to produce the
reverse of happiness. By happiness is intended pleasure, and the absence of
pain; by unhappiness, pain, and the privation of pleasure. ' 6

This is clearly a consequentialist
theory since what is right is being determined by the consequences of an action
and the consequences that are taken to be good are those that produce happiness.
In this initial formulation at least, happiness is being equated with the
sensation of pleasure and the absence of pain.

Because consequentialism is here
being combined with a theory that states that good outcomes are those that
produce happiness, it is called hedonistic conse­quentialism. Indeed, this
phrase is often what is meant by the term utilitarianism and that is how I shall
use this term. Mill describes his theory as utilitarianism. He clearly intends
to capture by this term that it is both a consequentialist doctrine and one that
gives intrinsic value to happiness. However, sometimes the term utilitarianism
is used synonymously with consequentialism. This should not cause any undue
problems since the context of the use usually clarifies which sense is
intended.

One of the obvious features in favor
of this sort of approach to ethical problems is that it reduces all issues of
value to one common currency of pleasure and the absence of pain This should, in
principle, make it easier to arrive at a solution to ethical problems. The right
action to perform will just be that action which produces the greatest balance
of pleasure over pain. However, this seeming simplicity masks many problems. How
exactly are we to measure these sensations of pleasure and pain? Mill himself
argues later in the essay that there are different sorts of pleasure. He
describes these as intellectual and sensual and claims that the intellectual
pleasures are more valuable than the sensual ones. How are pleasure and pain to
be recognized in those individuals who cannot express their
experiences?

Mill recognized some of the
difficulties with his initial formulation of the doctrine where he equates
happiness with the sensation of pleasure and the absence of pain . Indeed,
towards the end of the essay he starts to describe happiness as ‘a
concrete whole'6 which comprises the concrete things
that individuals desire. The individual is happy then in proportion to the
amount of his or her desires are satisfied, in proportion as he or she has what
he or she prefers. It should be noted, however, that this sort of position is in
direct opposition to earlier parts of Mill's essay where he specifically
distinguishes happiness from satisfaction or contentment.7

However, this move away from taking
happiness to refer to some mental state of pleasure and the absence of pain to
considering it as a reflection of desire satisfaction is what is reflected in
contemporary consequentialist theories. These theories, then, are also
consequentialist adhering to the claim that outcomes be as good as possible.
However, they combine this with a different view about what constitutes a good
outcome.

Interest or
preference consequentialism

Recent formulations of
consequentialist theories take the interest or preference satisfaction of those
affected to be what counts as a good outcome. Singer advocates the former view
in his book Practical Ethics 8and the latter position is argued
for by Hare in his book Moral Thinking9. Interests are taken to encompass
anything that individuals desire. Singer, for example, lists the following
interests:

‘. . .
the
interest in avoiding pain, in developing one's abilities, in satisfying basic
needs for food and shelter, in enjoying warm personal relationships, in being
free to pursue one's projects without interference. ' 10

One of the obvious questions with
this sort of account is what sort of beings can he said to have interests and
are there some interests, for example, in the continuation of one's own
existence, that some beings cannot possess? If we consider the beginning of
life, can the fetus at all stages of its development be said to possess
interests? Even if it can possess some interests, do these include an interest
in the prolongation of its life? If the interests of the fetus conflict with the
interests of other individuals, how are these conflicting interests to be
weighed in order that the maximum satisfaction of interests be
achieved?

These difficulties will be raised
later when the adoption of interest or preference consequentialism is considered
in particular cases. Interest or preference consequentialism is arguably
preferable to hedonistic consequentialism, since there are many problems
associated with the measurement of the sensation of pleasure which are apparent
in the hedonic calculus proposed by Bentham11.

2.3 DEONTOLOGICAL
ETHICAL THEORIES

If we return to the
‘cancer
example', we might say
that what is important to consider here is not what will cause the best outcome.
Rather, certain features of the situation make certain actions right or wrong in
themselves. For example, one such character­istic in this example might be
telling the truth. Although this might sometimes be overridden, the rightness of
telling the truth is something intrinsic to truth telling itself and is not
dependent on truth telling resulting in good consequences. This is to take a
deontological approach, which can be contrasted to the way that the rule
consequentialist viewed truth telling (rule consequentialism, above) where the
rightness of truth telling was justified in terms of it being instrumental to
achieving the best outcome.

Perhaps the major point of
difference between deontological ethical theories and consequentialist ethical
theories is that the former take rightness to he primary. As we have seen, for
consequenialists, what is right does not have any independent standing but is
defined in terms of what produces good outcomes. It is then this latter notion
that receives an independent explanation. In the case of deontological ethical
theories, certain actions are intrinsically right and their rightness is not
dependent on some further claim such that they are productive of the best
outcomes. In fact, the best outcome will be achieved, in deontological terms, if
the right action is performed. This is because the right action determines what
is the best outcome. Clearly, if a view like this is held, then some account is
necessary of what makes certain characteristics right. Why should something like
telling the truth be regarded as something that is intrinsically right? The
following deontological theories provide answers to this
question.

2.3.1 Kant's
deontological ethical system

Just as Bentham and Mill provide the
classic statement of a hedonistic consequentialist view, so Kant's ethical
theory contains the classic statement of a deontological theory. Kant proposed a
test called the ‘Categorical
Imperative' which could
be used to test whether a certain rule, such as one ought to tell the truth, was
really a duty (see page 16). The Categorical Imperative is first formulated by
Kant as:

'Act only on the maxim through which you can at the same time
will that it should become a universal law. '12

What does this mean? To begin with,
what is a maxim? An example of a maxim that we might adopt is that we shall
always do the shopping on a Friday. Another one might be that we will always
take anything that we want even if it does not belong to us. From these
examples, we can see that a maxim is a subjective principle of action. It is a
principle that we have decided to adopt to govern our lives. In order to see if
our maxims are duties, we shall then have to see if they pass the test
incorporated in the Categorical
Imperative.

So what exactly is involved in this
test? As a minimum requirement for a maxim to be capable of becoming a universal
law, a law applicable to everyone, it must not contain contradictions when
stated in its universal form. Kant gives an example of a maxim which, if
universalized, would be self-contradictory. Let us suppose that we decided to
have as one of our subjective principles of action the maxim of making promises
which we had no intention of keeping. This could be a very useful maxim for us.
For example, I could borrow some money from you and promise to pay it back even
though I had no intention of doing this. However, Kant argues that such a maxim
could not become a universal law since it would be self-contradictory. He
writes:

‘How would things
stand if my maxim became a universal law? 'I then see straight away that this
maxim can never rank as a universal law of nature and be self-consistent, but
must necessarily contradict itself, ' 13

The contradiction present if this
maxim is universalized is that the practice of promise keeping would disappear.
This is because no one could rationally believe anyone's promises since they
would be aware that the other person had no intention of keeping them. To make a
promise implies having the intention of keeping it and hence it is contradictory
to both have and not have this intention. Indeed, it is difficult to see how
there could be these insincere or lying promises unless there were a practice of
promise keeping. This is because they derive what success they achieve from the
existence of the institution of promising. That is, from the fact that most
people make promises with the intention of keeping them.

Although lying promises fail this
test incorporated in the Categorical Imperative there are some maxims that are
not contradictory when universalized but are still not duties. This is because
they fail the second part of the test incorporated in the Categorical
Imperative. If we have as one of our subjective rules of action that we shall
just look after our own interests and not help others who might be in need of
our assistance, could this become a universal law? Kant
writes:

‘. . .it is impossible
to will that such a principle should hold everywhere as a law of nature. For a
will which decided in this way would he in conflict with itself, since many a
situation might arise in which the man needed love and sympathy from
others’
14

The suggestion here appears to be
first that there is no formal contradiction in everyone adopting the policy of
just looking after their own interests and not helping others in distress.
However, we shall find that we cannot both have this as one of our maxims and at
the same time want it as a universal law. That is, we would not choose this
maxim and also hold that everyone else should just look after their own
interests. The merits of Kant's argument about this point are hotly debated but
it is clear that Kant is suggesting a two-part test in his Categorical
Imperative since even if a maxim, when universalized, is not contradictory, it
does not automatically follow that it can become a law. It has also to pass the
second part of the test and be such that we can will it both as a subjective
principle and as a universal law.

The necessity of being able to
universalize our maxims, of acting as if you were legislating for everyone, is
not the only feature incorporated in Kant's account. In formulating principles
of action that pass this test we need to recognize that other human beings are
also ends in themselves and must not be treated as a means to a further end. If
we make a promise with no intention of keeping it then we are using someone as a
means towards an end which we desire but which they do not share. Finally, other
rational beings as well as ourselves will formulate principles and recognition
of this will impose restrictions on what maxims can pass the test of the
Categorical Imperative. These last two points are discussed in further detail in
Section
4.2.2when we consider Kant's justification of
the Principle of Autonomy.

If we return to the
‘cancer
example', the maxim of
telling the truth would appear to pass the test incorporated in the Categorical
Imperative. When this maxim is universalized and applied to everyone, there is
nothing self-contradictory in everyone telling the truth. In addition, if we
want to tell the truth ourselves we shall want other people also to tell us the
truth. This maxim therefore passes both tests and is thus a right-making
characteristic (see
ET1008: Section 12.3.2).

One of the major problems with
Kant's deontological system is that there might well be situations where more
than one thing is our duty. This in itself is not problematic except where these
duties conflict in the sense that it is not possible to perform an action which
is in conformity with both. Arguably, this situation might be said to arise in
the ‘cancer example' where it might be claimed that the two duties of
telling the truth and not harming someone are in conflict.

2.3.2 Ross'
deontological ethical system

An account that could remedy this
problem was put forward by Ross in two books published in the 1930s called
The Right and the Good15and The Foundations of Ethics'.
Ross proposed that certain duties such as fidelity, beneficence and justice
be regarded as what he called prima facie duties. These duties are those that we
just, from our ordinary moral convictions, regarded as duties. He recognized
that in some situations these could conflict and the duty that was finally
decided to be applicable in the particular situation would be regarded as our
absolute duty in that situation.

If we return to the
‘cancer
example' again, Ross
might have argued that there are two prima facie principles involved, the
principle of non-malfeasance, that is, the non­infliction of harm, and the
principle of telling the truth. Our ordinary moral intuition reveals that these
are prima facie duties and where they conflict, we must somehow find the
greatest balance of right over wrong in order to discover what is our absolute
duty in this case.

2.4 EVALUATION OF CONSEQUENTIALIST AND DEONTOLOGICAL
THEORIES

Throughout this course, we shall see
in detail the implications of adopting one or other of these approaches, but I
will make a few points now about these competing theories.

Consequentialist theories have what
seems, on the face of it, to be an advantage since there is only one thing that
is claimed to have intrinsic value. For Mill this was happiness and for other
philosophers it was preference or interest satisfaction. Everything of value can
be reduced to the one common currency of happiness or interest satisfaction.
Consequently, everything of value can be directly compared since all value
issues are explicable in terms of one currency. This would appear to make moral
dilemmas more easy to solve and less intractable. In the ‘cancer
example' we would just
have to consider the interests of the individuals affected in this situation and
the right action to perform will be that action which maximizes interest
satisfaction.

However, one might have an initial
feeling that not all values are indeed commensurable and that any account that
claims they are is not reflecting the sophistication of moral thought. Also,
despite its apparent simplicity, any account which evaluates actions or rules in
terms of consequences is going to have to weigh probabilities of certain
consequences against the amount of good that those consequences might yield .
Therefore, any calculation might be very difficult to
undertake.

Perhaps the most fundamental
criticism that can be leveled at consequentialist theories is that separate
individuals are no longer of paramount importance in their account. The
maximization of happiness or interest satisfaction is the goal to be achieved.
If this is achieved by an unequal distribution of happiness between individuals,
then nothing can be done about this. We shall see how this ultimately leads them
to give an unsatisfactory account of the Principle of Justice in Section 6.

An initial advantage of
deontological theories is that they appear to advocate as right what is
generally recognized by the majority of people as being right. However, what
characterizes a moral dilemma is that this is usually a situation in which these
prima facie duties conflict. It might be felt that deontological theories do not
provide a decision procedure to deal with these sorts of cases. Any talk of
‘weighing' the various prima facie duties against one another is not
descriptive of a method at all. However, maybe this is all that can be hoped for
and after the situation has been suitably clarified, we shall in some sense see
what course of action will be right.

The fundamental advantage that
deontological theories have over consequentialist theories is their recognition
of the importance of individuals. It is not legitimate to sacrifice individuals
for the sake of a particular favorable outcome. Our argument is for the
importance of this claim throughout the book.

LEARNING
EXERCISES

1. ‘There is nothing wrong with undertaking
a pregnancy with the sole purpose of providing fetal tissue'. What
justification, if any, could be given for this claim from within a
consequentialist ethic?

2. If three people's lives can be saved by using the
organs from a fourth person, ought we to kill the fourth person to obtain
his or her organs? Analyze this question from both a deontological and
consequentialist perspective.